I have grooves under my eyes. Are they eye bags, tear troughs or festoons? What is the best treatment? (Photo)
Doctor Answers 5
Tear trough, lower orbital rim hollow and malar ligament
The first 1 inch of the diagonal groove from the inner corner of the eye is called a tear trough. Although there is a slight bulge above the tear trough, I would not define your lower eyelid bulge as an eyebag. A very small volume of Restylane should be able to hide the lower eyelid bulge to blend it smoothly to the upper cheek by your nose. I have much more extreme examples of true eyebags which I was able to blend smoothly to the upper cheek.
Lower orbital rim hollowing
The hollowing around the outer rim of the eye is not called a tear trough. If there is a slight concavity or almost a fingerprint sized depression between the outer eyelashes to the cheekbone, this can be filled to appear smoother from the eyelash to the cheekbone. This can give a higher and fuller cheekbone appearance by reducing the concavity under the lower eyelashes.
Malar ligament AKA Cheek ligament
A continuation of the tear trough as is travels diagonally across the cheek is called the malar ligament. If the cheek and lower eyelid tissues are overflowing the ligament, then you can call it a festoon. Since it is flat above and below the ligament, I just call it a malar ligament. I like to fill deep below the malar ligament to pop-out the slight indentation of this area of the cheek.
Completing the Triad => Apple cheeks.
Using relatively small volumes of 1-3 cc's (1 cc is the same as 1/5th of a teaspoon) smoothing out the concave areas under the lower eyelash line can make the cheeks blend more seamlessly to the the lower eyelash line, without creating a bloated, pillow face appearance.
I like Restylane for these areas and using a microcannula to inject to reduce the chance of bruising and allows more delicate sculpted result.
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Restylane workds great for tear troughs
Tear Trough Injections with Restylane
For before and after pictures of the tear trough injection procedure, click on the link below.